[Methods for surgical closure of pharyngo-cutaneous fistulas after laryngectomy]

Salivary fistulas after laryngectomy and radiotherapy can be treated with different reconstructive procedures if spontaneous closure fails to occur. In small fistulas local supraclavicular flaps are useful if not altered by radiotherapy. Larger fistulas can be closed with pectoralis major flaps. If these methods fail and there is a large defect in the pharynx, free tissue transplants can be used. For this purpose the "single" or "double" jejunal patch can be recommended. The double patch is used for fistulas with large skin defects, since the outer patch from which the mucosa is removed will take split skin. If there is severe infection and tissue alteration by radiotherapy, free omentum transplantation is an excellent method for closure of a fistulas, since in addition to immunological reactivity it easily takes split skin. the vanous methods mentioned are not equal in their applications and are used depending on the size of defect present. In particular, the use of intestinal grafts depends on the general health of the patient affected.